HHS’ recent mandate to implement comprehensive nutrition education and training across US medical education organizations received mixed responses across industry stakeholders.
“Medical schools talk about nutrition but fail to teach it,” HHS Secretary Robert F Kennedy Jr said in an Aug. 27 statement. “We demand immediate measurable reforms to embed nutrition education across every stage of medical training, holding institutions accountable for progress, and equip every future physician with the tools to prevent disease – not just treat it.”
HHS and the Department of Education issued a Sept. 10 deadline for medical education organizations to submit written plans outlining about nutrition education requirements across premedical standards, medical school curricula integration, medical licensing examinations, residency requirements, board certification and continuing education.
Should nutrition education be a part of medical training?
Proponents of the mandate welcome the initiative, citing a need for more nutrition training for healthcare professionals through evidence-based research and collaborations with medical educators.
Council for Responsible Nutrition (CRN) President and CEO Steve Mister called the mandate “encouraging” and said that “healthcare providers should get this training before they are certified to practice.”
CRN’s members include suppliers and manufacturers of dietary ingredients and supplements. The organization provided education for pharmacists on the role of nutrients like vitamin D in health, hosted educational opportunities for doctors on the impact of prenatal supplements for the health of mothers and infants and education programs for dietitians on supplements’ role in filling nutrition gaps.
“We’ve been calling on schools of medicine, pharmacy and dietetics to acknowledge the relationship between nutrition and better health, as well as a proper role for dietary supplements,” Mister said.
The American College of Lifestyle Medicine (ACLM) also supports HHS’ called for reform in medical school nutrition education and emphasized evidence-based training from undergraduate and graduate, including residency and fellowship, medical school.
While there is “overwhelming evidence” connecting diet to health outcomes, most physicians “received too little formal education in this area,” said Padmaja Patel, president, ACLM.
ACLM provided more than 1.2 million hours of nutrition and lifestyle medicine education to physicians and other health professionals since its inception in 2004. Implementing nutrition education in medical schools often faces challenges like “curricular overload, limited faculty expertise and misconceptions about accreditation and assessment,” stated Brenda Rea, medical director of education, ACLM. She added ACLM’s existing curricula, programs and partnerships may fill those gaps.
Dietitians: Nutrition education already exists, a mandate will only overload doctors
Nutrition advocates and registered dietitians argue that the mandate simply duplicates the existing field of medical nutrition.
While including more nutrition education is critical for doctors to enhance their knowledge of diet-related health outcomes, registered dietitians “are missing in this conversation,” said Amanda Sauceda, a registered dietitian and lecturer at California State University, Long Beach.
HHS’ “hope for a health professional to provide the latest nutrition advice already exists in the form of a registered dietitian. Dietitians are experts at weaving nutrition science with patient concerns (i.e. food accessibility and cooking skills) and then providing them with actionable steps,” Sauceda explained.
Giving organizations less than two weeks to comment also puts medical schools at risk of developing a program that is more “performative than useful,” said Marion Nestle, nutrition and public policy expert.
While adding on nutrition education to medical schools “could help,” ultimately “nutrition in clinical practice is not simple,” and the most effective path is to teach students how to refer patients who need nutrition intervention to a well-trained dietitian, Nestle said.
“It depends on what is taught. The big demand for nutrition education is to teach students and practitioners how to assess nutritional needs and deal with diet-related chronic diseases along with a lot of other social, economic and cultural factors. To expect medical schools to do this well, quickly, is a big ask,” she added.
Registered dietitians ‘need to be utilized more’
While enhanced nutrition education in the medical field is “a step in the right direction,” adding this mandate to a physician’s workload could create more confusion, said Carla Hernandez, registered dietitian who specializes in women’s health.
“Nutrition is foundational to prevention, yet most physicians receive little formal education on it. But we also need to be realistic: Doctors already operate under time constraints and typically treat acute concerns. Even with more training, they often won’t have the bandwidth to dive into nutrition counseling,” argued Hernandez.
She pointed out that registered dietitians are equipped with between five to seven years of specialized education in nutrition science and clinical application, which will not require “reinventing the wheel” that the mandate suggests.
Instead, a more effective and efficient approach would be integrating dietitians into medical settings and guaranteeing insurance coverage.
“We already exist in the healthcare system, we just need to be utilized more,” she added.
Gretchen Wallace, registered dietitian with Full Life Nutrition Counseling LLC echoed these sentiments, adding that doctors’ heavy workloads prevent them from regular follow-ups and delivering appropriate counseling and education, “which is necessary for long-term success with nutrition therapy interventions.”
Wallace continued: “We want to support doctors in being doctors, not asking them to manage an entirely new dimension of patient care. We don’t expect doctors to provide physical therapy, mental health therapy or occupational therapy. We shouldn’t expect doctors to provide medical nutrition therapy.”
